RESUMO
A 32-year old man with Sturge-Weber syndrome, a rare congenital disease of multiple angiomatous lesions including cervical cortex, face, oral soft tissues, larynx and trachea, underwent the excision of a back lipoma. His hemangioma which extended into the region of the right ophthalmic nerve and superior maxillary nerve is extremely large. He also had mental retardation and epilepsy. No apparent hemangioma was found in his oral cavity, pharynxes, larynx and trachea by preoperative exam. His hemangioma made it difficult to cover his mouth and nose by usual face mask. Though we first considered awake intubation, he was difficult to obey our command. So we searched for the face mask covering his nose and mouth without pressing his facial angioma. Finally, we discovered the full-face mask for NIPPV. After induction with propofol, we confirmed the perfect mask fit, and ventilation by two-person method was effective. Then we administered rocuronium and fentanyl, and intubated without difficulty. The patient was maintained by sevoflurane. He was hemodynamically stable. He was extubated without bleeding and respiratory problems. We experienced general anesthesia of a patient with Sturge-Weber syndrome who had a giant facial hemangioma. With full-face NIPPV mask we safely induced general anesthesia.
